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Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data
Open accessAbstract
Background: Governments worldwide recommend daily consumption of fruit and vegetables. We examine whether this benefits health in the general population of England. Methods: Cox regression was used to estimate HRs and 95% CI for an association between fruit and vegetable consumption and all-cause, cancer and cardiovascular mortality, adjusting for age, sex, social class, education, BMI, alcohol consumption and physical activity, in 65 226 participants aged 35+ years in the 2001–2008 Health Surveys for England, annual surveys of nationally representative random samples of the non-institutionalised population of England linked to mortality data (median follow-up: 7.7 years). Results: Fruit and vegetable consumption was associated with decreased all-cause mortality (adjusted HR for 7+ portions 0.67 (95% CI 0.58 to 0.78), reference category <1 portion). This association was more pronounced when excluding deaths within a year of baseline (0.58 (0.46 to 0.71)). Fruit and vegetable consumption was associated with reduced cancer (0.75 (0.59–0.96)) and cardiovascular mortality (0.69 (0.53 to 0.88)). Vegetables may have a stronger association with mortality than fruit (HR for 2 to 3 portions 0.81 (0.73 to 0.89) and 0.90 (0.82 to 0.98), respectively). Consumption of vegetables (0.85 (0.81 to 0.89) per portion) or salad (0.87 (0.82 to 0.92) per portion) were most protective, while frozen/canned fruit consumption was apparently associated with increased mortality (1.17 (1.07 to 1.28) per portion). Conclusions: A robust inverse association exists between fruit and vegetable consumption and mortality, with benefits seen in up to 7+ portions daily. Further investigations into the effects of different types of fruit and vegetables are warranted.
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“other studies have shown a dose–response relationship between mental42 and physical health43 up to seven portions a day.”
From Major health-related behaviours and mental well-being in the general population: the Health Survey for England (2014) · cites this paper as [43]
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“Associations with all-cause mortality [ 2 , 3 ]”
From Increasing vegetable intakes: rationale and systematic review of published interventions (2016) · cites this paper as [2]
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“mortality from cardiovascular disease [ 2 , 3 ], including coronary heart disease [ 4 ] and stroke [ 5 , 6 ], are well evidenced.”
From Increasing vegetable intakes: rationale and systematic review of published interventions (2016) · cites this paper as [2]
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“Observational studies demonstrate reduced risk of cardiovascular disease [ 2 ], type II diabetes [ 34 ], non-gallstone-related acute pancreatitis [ 33 ], various cancers [ 2 , 47 – 50 ] and cognitive decline [ 32 ].”
From Increasing vegetable intakes: rationale and systematic review of published interventions (2016) · cites this paper as [2]
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Metadata
- Authors
- Oyebode, O., Gordon-Dseagu, V., Walker, A., & Mindell, J. S.
- Affiliations
- University College London (GB)
- Corresponding author
- Oyebode, Oyinlola
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2014-03-31
- Volume
- 68
- Issue
- 9
- Pages
- 856-862
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC4145465
- OpenAlex
- W2158916521
- Cited by
- 437
- References
- 32
- Citations by year
- 2026: 5 · 2025: 20 · 2024: 24 · 2023: 18 · 2022: 36 · 2021: 48 · 2020: 36 · 2019: 40 · 2018: 43 · 2017: 48 · 2016: 52 · 2015: 48 · 2014: 18
- FWCI
- 55.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Epidemiology & Community Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Diabetes UK (08/0003752)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- fruit and vegetable intake, all-cause mortality, cancer mortality, cardiovascular mortality, dietary recommendations, vegetables, salads, Health Survey for England
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Cause of Death, England, Feeding Behavior, Female, Fruit, Health Surveys, Humans, Male, Middle Aged, Neoplasms, Risk Factors, Vegetables
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